You were saying that our health workers are being trained in a professionally- and pathology-centered medicine rather than in a client-centered medicine. What would a client-centered medicine be like?

Some health workers are already practicing client centered medicine. For instance, someone seeing a person with an ailment might ask, ''What's worked for you when you've had this problem before?" Maybe the person has used hot baths for menstrual cramps or an over-the-counter remedy for indigestion. If a person has strong feelings against pharmaceuticals, an herbal remedy or a homeopathic remedy may be more effective—for him.

I would think that one good local resource for information on drugs would be your local pharmacist. How can a person best use their pharmacist?

The pharmacist is probably the most overlooked and underused health professional. It's a shame, because not too many years ago, the pharmacist was a respected and important source of drug information within the community.

One of the big problems is the way pharmacists are used in the big chain drugstores. The center of these stores is devoted to selling fishing tackle and cosmetics and motor oil, while the pharmacy is stuck in some little corner way in the back. The pharmacists are kept out of sight, filling ''scripts," as prescriptions are called, as fast as their hands can move. They frequently receive incentive pay for the number of scripts filled in a day, and they're not encouraged to spend any time giving people drug information.

This is a very sad misuse of talent, because the pharmacist is a well-trained pro who is perfectly capable of answering most questions on prescription and over-the-counter drugs.

This assembly-line approach allows the chain stores to charge less for prescriptions—which makes survival difficult for the old-fashioned pharmacist. With a small pharmacist who runs the store himself, you can develop a useful, personal relationship. Look for an individual who is good at communicating and is willing to take the time to deal with your concerns. Ask your friends about the pharmacists they use. And once you find a good one, let him know you appreciate his services.

So you'd advise trying to understand a particular symptom instead of just trying to get rid of it.

Sure. Symptoms are an early warning signal. Eliminating symptoms without paying attention to the underlying process that's producing the symptom is like putting a penny in the fuse box when a fuse blows. The next warning is likely to be something a lot more heavy-duty.

That doesn't mean I think we should all be masochists. If you've got a headache and you know it's from stress and muscle tension, there's nothing wrong with taking aspirin. If you have severe menstrual cramps, codeine may be very effective. If you have diarrhea, you may decide to take codeine or Lomotil even though you know that the diarrhea is helping to cure you of something else—because the inconvenience just isn't worth it. And there are some cases in which a drug actually attacks the root of a problem instead of just removing a symptom. If I had a bad sore throat, I'd have it cultured. If the culture grew out strep, I'd be the first in line to get some penicillin.

It should always be a carefully weighed decision whether or not to use a given drug. And I think that it should be the informed consumer who ultimately makes those decisions.

What other kinds of products are available in drugstores that might be good self-care tools?

Tom Ferguson, M.D. (1943-2006), was a pioneering physician, author, and researcher who virtually led the movement to advocate informed self-care as the starting point for good health. Dr. Ferguson studied and wrote......more

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